專科護理師工作活動、工作滿意度與留任意願關係之探討

背景：為順應現今醫療體系的變化，專科護理師(Nurse Practitioner, NP)已成為輔助醫療重要的角色。因醫院層級及科別屬性不同，加上採用醫、護共管模式，使得NP工作項目分配不均、花費時間及工作負荷量增加，進而影響工作滿意度及留任意願，國內少見探討NP工作活動、工作滿意度與留任意願關係之調查，此研究將有助於NP適應工作環境與改善工作內容，並提升其專業價值。目的：探討專科護理師工作活動、工作滿意度與留任意願之關係。方法：採橫斷性相關性研究設計，以方便取樣選取南部五間不同層級醫院之專科護理師為研究對象，總收案人數為221名，利用工作項目與時間分配、麥森納工作滿意度及留任意願等問卷進行資料收集，統計分析採描述性統計、相關性分析及線性迴歸分析。結果：結果發現教育程度、服務醫院等級、NP執照、工作地點及值班在工作活動皆有顯著性差異(p < .05)，性別、服務年資、NP執照在工作滿意度有顯著性差異(p < .05)，工作地點、輪班在留任意願有顯著性差異(p < .05)；相關性分析結果發現每日工作時數與工作活動呈顯著正相關(r= .157, p < .01)，每日工作時數與工作滿意度為顯著負相關(r= -.201, p < .01)，工作活動、工作滿意度與留任意願皆有顯著正相關(r= .151-507, p < .05)。線性迴歸發現輪班、工作活動及工作滿意度為留任意願的預測因素，總解釋變異量為32.9%。結論：輪班、工作活動及工作滿意度為留任意願重要的相關因子。建議醫院管理者能重視NP所提供的臨床照護及工作內容，監測及調整NP的工作活動、輪班情形及每日工作時數，以增加工作滿意度，進而提升留任的意願。

關鍵字

專科護理師；工作滿意度；工作活動；留任意願

並列摘要

Background: The role of nurse practitioners has become more important in assisting physicians as our medical system changes. However, due to different level of hospitals and specialties in addition to physician-nurse co-management, nurse practitioners had uneven job allocation, increasing working load and increasing time spent on their job. This influenced their job satisfaction and the intent to stay. Since there are not many researches investigating this issue, this study shall help understanding nurse practitioners' current clinical working condition. Purpose: This study aims to investigate into the relation among nurse practitioners' work pattern, job satisfaction, and their willingness to stay in medical centers in Southern Taiwan. Method: This study was a descriptive cross-sectional research design. A questionnaire survey was done in five hospitals of different levels in Southern Taiwan. Two hundred and twenty-one nurse practitioners participated in this study by convenience sampling. The data collected include job content, time allocation, Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), and willingness to stay in current hospital. Descriptive Statistics, correlation analysis, and linear regression analysis were used in this study. Result: Education level, hospital classification, shift, nurse practitioner license, working site are significant different in job activities (p < .05). Gender, working length and nurse practitioner license are significant different in job satisfaction (p < .05). Where as both working site and shift also have significant different in intent to stay (p < .05). There is significant positive correlation between working hours per day and working activity (r= .157, p < .01), while working hours and job satisfaction is negatively correlated (r= -.201, p < .01). Job activities, job satisfaction and intent to stay shows significant positive correlation (r=.151-507, p < .05). Linear regression analysis showed that shift, job activities, and job satisfaction are predictive factors; total variance explained is 32.9%. Conclusion: This study showed that shift, job activities, and job satisfaction are important factors regarding staying willingness. In order to increase nurse practitioners' willingness to stay as well as job satisfaction, we suggest that hospital administers value the clinical care and work content of nurse practitioners, monitor and adjust the work activities, shift, and daily working hours of nurse practitioners.